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Viewpoint |

Unintended Consequences of Current Breastfeeding Initiatives ONLINE FIRST

Joel L. Bass, MD1; Tina Gartley, MD1; Ronald Kleinman, MD2
[+] Author Affiliations
1Department of Pediatrics, Newton-Wellesley Hospital, Newton, Massachusetts
2Department of Pediatrics, Massachusetts General Hospital, Boston
JAMA Pediatr. Published online August 22, 2016. doi:10.1001/jamapediatrics.2016.1529
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This Viewpoint argues that rigid adherence to the Ten Steps to Successful Breastfeeding component of the Baby-Friendly Hospital Initiative may inadvertently promote potentially hazardous practices.

Promoting and supporting breastfeeding during the postpartum period has been an important and appropriate priority for maternity units in recent years. The Ten Steps to Successful Breastfeeding of the Baby-Friendly Hospital Initiative have been implemented by an increasing number of hospitals as the standard of care for optimally supporting breastfeeding from birth to hospital discharge.1 As some or all of these steps are increasingly being promoted as standard of care by government agencies (eg, the Centers for Disease Control and Prevention) and by The Joint Commission, it is important to be certain that the basis for the recommendations has been documented in reproducible scientific studies and that the benefits of the practices recommended outweigh the risks. Unfortunately, there is now emerging evidence that full compliance with the 10 steps of the initiative may inadvertently be promoting potentially hazardous practices and/or having counterproductive outcomes.

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